Wednesday, 17 July 2013

Managing unwanted fertility – India’s priority # one

Dr. Devendra
Kothari

Population
and Development Analyst,

Forum for
Population Action

The problem of unwanted fertility is extremely serious considering India’s
pressing economic and social scenarios.

The World
Population Day, annually observed on July 11, is an occasion to engage people, spur commitment and spark actions
related to the opportunities and challenges presented by the growing
population.

With 1.27 billion (2013) people and still growing,
India is getting dangerously overcrowded. India is currently the second most populous nation in the world.
It will surpass China as the most populous within 8-10 years. Its population is projected to peak at 1.65 billion in
2065. China at its peak in 2030 will have 1.45 billion people. In fact, when
China peaks, India will have already surpassed it in population (UN World
Population Prospects, 2012). Many Indians
see these emerging demographics as a critical advantage in competition with the
nation it regards as its chief rival –
China. With around 70% of the population under 35, India
can afford to dream to become economic power in the world before the middle of
this century.
However underneath, this rosy outlook for India epitomizing the country’s
ability to surpass China on the back of a younger population lays some
difficulties, especially deteriorating level of education and nutrition. It is not enough to have lots of young people — these
young people need to be properly educated/skilled to fully contribute to the
economy. Today, more children are going to school but what they are
learning is not clear. The Annual Status of Education
Report 2012 by Prathamshows that
the number of Class V students who could not read a Class II level text or
solve a simple arithmetic problem has increased. In 2010, 46.3% of children in
this category failed to make the cut and this shot up to 51.8% in 2011 and
53.2% in 2012. Can
they get any job in the market if they continue such education? Can industry
get the professionals it is looking for?[1]

Current population growth is mainly
fueled by unwanted fertility. More than four in ten pregnancies are unintended
by the women who experience them, and half or more of these pregnancies result
in births that spur continued population growth. Around 26.5 million children
were born in the year 2012 and out of this almost 6.0 million pregnancies had
been classified as unplanned. The government has to spend on an average around
Rs. 8760 per year to raise a child until the age of 15. By avoiding unwanted
pregnancies, the government would have saved at least around Rs. 52560 million
in that year alone. Further, it is estimated that currently there are around 460
million people out of 1270 million in India in 2013 that are product of
unplanned pregnancies, and most of them are from the lower economic strata
(based on the findings of National Family Health Surveys). The consequences of
unwanted fertility are serious, slowing down the process of socio-economic
development. It is because unwanted childbearing results in poor physical
growth, reduced school performance, diminished
concentration in daily tasks thus
impacting work capacity and work output resulting in diminished earning
capacity. The impact of this is reflected in widespread hunger, malnutrition, poverty,
unemployment, weak governance as well as increasing scarcity of basic resources
like food, water and space in several parts of India despite concerted
developmental efforts since 1991. [2]

How
to mange unwanted fertility? A popularly held belief by India’s policy makers
is that as a country becomes economically more prosperous, its fertility
declines significantly and leads to a stable population. However, this is a
simplistic view of a complex phenomenon.
Since the introduction of market-based economic reforms in 1991, India
has become one of the fasted growing major economies in the world. The reforms
completed 20 years in July 2011, however, during this period, India’s
population increased by 365 million, much more than the population of USA - the
third most populous country in the world.
This
raises the question: Is Development the Best Contraceptive or Are
Contraceptives? It is argued that
there is a need to go beyond the prevailing notion that socio-economic
development is an essential precondition for fertility transition, since it
provided only a partial explanation for the monumental changes taking place in
fertility behavior, especially in low-income economies like Bangladesh and
Andhra Pradesh.[3]

More than four in ten pregnancies are unintended by the
women who experience them, and half or more of these pregnancies result in
births that spur continued population growth. While India’s population
continues to grow by 17-18 million annually, 15 million married women in the
reproductive ages, mostly in Four Large North Indian (FLNI) States of Bihar,
Madhya Pradesh, Rajasthan and Uttar Pradesh, seek to postpone childbearing,
space births, or stop having children, but are not using a modern method of
contraception that is having unmet need for family planning services. Often, these women travel far from their
communities to reach a government health facility, only to return home “empty
handed” due to shortages, stock outs, lack of choices and/or non
availability of doctors and paramedical staff. When women are thus turned away,
they are unable to protect themselves from unwanted pregnancies. Rural Development
MinisterJairam Rameshcandidly admitted
that in many parts of India, public health system does not exist. “We all know
that the health system in India has collapsed”, he added. Today, the single
most important measure to manage unwanted fertility is to revamp the public health system to provide services looking to the needs of clients.

Incidence
of unintended frequencies can be dramatically reduced, if not eliminated,
within a decade by revamping family planning program, as has been done in Andhra Pradesh. If Andhra - with little outside help -
can manage its population issue under relatively low literacy and high poverty,
there is no reason why Four Large North Indian States, with lesser problems and
with increasingly generous support from the Government of India under National
Rural Health Mission (NRHM), should fail so spectacularly in managing unwanted
fertility.

It appears that the population and
related issues have not been given due importance in the development debate of
India. Demography, therefore, in the next 10 years or so will pose serious
challenges to economic growth, democracy and national unity by its sheer size.
The writing is on wall. The question is not whether we act or not, but whether
we act now or later and deal with much more dire and expensive consequences.
Hope India’s political landscape which suddenly has energetic younger leaders
will take it seriously and lead the way.[4]

[4]The term younger is a flexible one, ranging from Akhilesh Yadav and
Rahul Gandhi in their early 40s, Shivraj Singh Chauhan, Vashundhra Raje, Mayawati
in their 50s, and Nitesh Kumar and Narendra
Modi in their early 60s.

1 comment:

Hello Sir, I am student from IIHMR New Delhi. I saw your presentation in NRHM Conference held on 8th August in IEG Delhi. It was a good presentation. Your Blog got my attention. It also carries a good detail of your idea. Nice.